Medicare post-acute care

MedPAC Makes 2026 Medicare Rate Recommendations

The Medicare Payment Advisory Commission recently released “Report to the Congress: Medicare Payment Policy,” its required March report to Congress. In addition to addressing a variety of Medicare issues, MedPAC presented its 2026 Medicare rate recommendations to Congress. Those recommendations are: Hospital inpatient and outpatient services – the rate increase in current law plus one percent. MedPAC also reiterated its past recommendation that Medicare redistribute current Medicare disproportionate share (Medicare DSH) and uncompensated care payments through MedPAC’s own mechanism, the Medicare Safety-Net Index (MSNI) it introduced in 2023, maintaining that doing so, when supplemented with an additional $4 billion in [...]

joe2025-03-20T14:44:09-04:00March 25, 2025|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for March 20

The following is the latest health policy news from the federal government for March 14-20. Some of the language used below is taken directly from government documents. The White House The White House has rescinded Executive Order 13994 of January 21, 2021, titled “Ensuring a Data-Driven Response to COVID-19 and Future High-Consequence Public Health Threats.” In response to this action, CMS rescinded its November 22, 2022 memo “The Importance of Timely Use of COVID-19 Therapeutics,” the purpose of which, according the memo, was “…to highlight the importance of providing timely access to available COVID-19 therapeutics to patients who test positive [...]

joe2025-03-20T16:00:25-04:00March 20, 2025|340b, Centers for Medicare & Medicaid Services, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for January 23

The Administration Public Communication The new administration has directed HHS to pause all external communications, including announcements, advisories, regular publications, and web site updates. According to a published report, "HHS has issued a pause on mass communications and public appearances that are not directly related to emergencies or critical to preserving health," a spokesperson wrote in an email. "This is a short pause to allow the new team to set up a process for review and prioritization. There are exceptions for announcements that HHS divisions believe are mission critical, but they will be made on a case-by-case basis." The directive [...]

MedPAC Meets

MedPAC’s commissioners held their latest public meetings on Thursday, January 13 and Friday, January 14. The subjects on the meetings’ agenda were: assessing payment adequacy and updating payments: physician and other health professional services assessing payment adequacy and updating payments: hospital inpatient and outpatient services assessing payment adequacy and updating payments: skilled nursing facility services; home health agency services; inpatient rehabilitation facility services; outpatient dialysis services; and hospice services eliminating Medicare’s coverage limits on stays in freestanding inpatient psychiatric facilities Medicare prescription drug program (Part D): status report ambulatory surgical center services: status report the Medicare Advantage program: status report [...]

joe2025-01-21T17:23:04-05:00January 22, 2025|Centers for Medicare & Medicaid Services, Federal Update, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for December 5

The following is the latest health policy news from the federal government for November 22 – December 5. Some of the language used below is taken directly from government documents. Congress The House has posted its session calendar for 2025. Find that calendar here. Yesterday, House Republicans made an offer to House Democrats regarding health care provisions to be included in the continuing resolution (CR) that must pass before December 20. The offer is a conversation-opener and very few details are available. Although most of the proposed policies have bipartisan support, there are some tangible policy differences, including House Democrats’ [...]

joe2024-12-05T17:14:33-05:00December 5, 2024|Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Federal Update, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Pennsylvania Update|

Federal Health Policy Update for November 7

The following is the latest health policy news from the federal government for November 1-7. Some of the language used below is taken directly from government documents. Medicare Payment Regulations Late last week CMS published four regulations describing how Medicare will pay certain providers in 2025. The following is a brief overview of those regulations. Medicare Outpatient Prospective Payment System Rate increase of 2.9 percent for outpatient and ambulatory surgical center services. New Conditions of Participation for obstetrical services. Additional payments for selected non-opioid treatments for pain relief. Minor modifications of the inpatient-only list. A change in the review time [...]

joe2024-11-07T16:26:47-05:00November 7, 2024|Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for October 24

The following is the latest health policy news from the federal government for October 18-24. Some of the language used below is taken directly from government documents. Centers for Medicare & Medicaid Services CMS has issued new guidance outlining regulatory requirements for hospitals to report specific data on COVID-19, flu, and RSV. The new weekly electronic reporting requirements will apply to short-term acute-care hospitals, long-term-care hospitals, critical access hospitals, Indian Health Service hospitals, children’s hospitals, and cancer hospitals, with other types of hospitals – psychiatric hospitals and distinct part units and inpatient rehabilitation hospitals and distinct part units – subject [...]

joe2024-10-24T14:58:32-04:00October 24, 2024|Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, hospitals, Medicaid, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

Federal Health Policy Update for October 17

The following is the latest health policy news from the federal government for October 11-17. Some of the language used below is taken directly from government documents. Aftermath of Hurricanes Helene and Milton CMS has updated its waivers and flexibilities to help health care providers respond to the damage caused by Hurricane Helene in South Carolina, Tennessee, Georgia, North Carolina, and Florida and by Hurricane Milton in Florida. Find the updated waivers and flexibilities here. Please note that these waivers are not dated and therefore require individual attention by affected providers. HHS has initiated a series of steps to help restore [...]

joe2024-10-17T15:58:08-04:00October 17, 2024|Centers for Medicare & Medicaid Services, hospitals, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

MedPAC Meets

MedPAC’s commissioners held their latest public meetings last week, on Thursday, October 10 and Friday, October 11. The subjects on the meetings’ agenda were: Medicare beneficiaries in nursing homes findings from MedPAC’s annual beneficiary and provider focus groups supplemental benefits in Medicare Advantage work plan for a mandated final report on the impact of recent changes to the home health prospective payment system initial estimates of home health care use among Medicare Advantage enrollees Go here for summaries, key points, actions, and the presentations offered at the meetings about each agenda item and go here for a transcript of the [...]

joe2024-10-17T09:11:39-04:00October 17, 2024|Medicare, Medicare post-acute care, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for August 30

The following is the latest health policy news from the federal government for August 23-30. Some of the language used below is taken directly from government documents. 340B Johnson & Johnson, the pharmaceutical, biotechnology, and medical technologies company, told health care providers this week that it would shift from the long-time 340B upfront discount approach to a rebate model for two of its drugs and that eligible 340B hospitals and other providers will need to purchase the prescription drugs Stelara and Xarelto at list price and then, after dispensing them to patients, will need to submit 340B rebate claims to [...]

joe2024-08-30T15:03:18-04:00August 30, 2024|340b, Centers for Medicare & Medicaid Services, health equity, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid long-term services and supports, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy, MedPAC, social determinants of health|